Transplantation for Patients Infected with Human Immunodeficiency Virus: No Longer Experimental but Not Yet Routine

Open Access
Publisher Website
Google Scholar
Abstract
The first successful solid-organ transplantations were performed in 1954, just 50 years ago. The first descriptions of acquired immunodeficiency syndrome (AIDS) are now >20 years old. Over the years, the 2 fields of solid-organ transplantation and AIDS care have provided some of the greatest clinical and ethical challenges that the biomedical community has encountered [1–4]. Until recently, human immunodeficiency virus (HIV) infection has been a contraindication for solid-organ transplantation, because of the inability to control viral replication in patients receiving exogenous immune suppression for the prevention of graft rejection [2]. The advent of improved combination antiretroviral therapies (ARTs) has improved the survival of many HIV-infected individuals [5]. One of the consequences of the prolonged survival of HIV-infected individuals has been the increasing impact of complications of common chronic illnesses. The impact of hypertension, chronic obstructive pulmonary disease, viral hepatitis, and diabetes is apparent in deaths due to liver, kidney, heart, and lung failure among patients who are HIV positive. Some of these diseases may be exacerbated by the side effects of antiretroviral therapy, which include hepatic dysfunction and altered lipid metabolism. However, as HIV replication is controlled and the incidence of opportunistic infection and malignancy declines, the approach to the long-term care of HIV-infected individuals with organ failure must be reassessed

This publication has 0 references indexed in Scilit: